Abstract
Background
Nurses caring for older people with delirium in hospitals often report stressful situations
that trouble their conscience and threaten their wellbeing in the workplace. These
situations are yet to be explored to gain a deeper understanding of troubled conscience
when nurses are involved in care below expected professional standards or their personal
values.
Aim
The purpose of this Interpretive Descriptive study was to explore the troubled conscience
amongst nurses caring for older people with delirium in hospital.
Method
The study was conducted at a regional health service with 250 acute in-patient hospital
beds in Victoria, Australia. Using Thorne's (2016) approach to Interpretative Description
(ID) allowed the results to be authentic and applicable to the nursing profession.
To extend the understanding of the data, thematic networks were generated.
Findings
The global theme that illuminated troubled conscience was ‘losing passion and injured self-image.’ The nurses were losing passion and had their self-image compromised because they
struggled to hold congruence between their ideal self and their actual self in their
workplace. The organising themes were an inability to execute care to personal satisfaction,
being incapacitated and constrained by the workplace environment, being involved in
negligent care and misconduct, feeling powerless and hopeless and seeking fulfilment
and contentment.
Conclusion
Re-conceiving the meaning of humane caring in nursing, empowering nurses’ voices,
avoiding perceived negligent care and misconduct, as well as practising self-care
through debriefing and physical exercise potentially reduces troubled conscience.
This study is a step towards greater understanding of the phenomenon and interventions
to support nurses’ passion, self-image, and integrity in their workplaces.
Keywords
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Article info
Publication history
Published online: September 28, 2022
Accepted:
September 6,
2022
Received in revised form:
August 16,
2022
Received:
April 26,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Australian College of Nursing Ltd. Published by Elsevier Ltd.
